Individual provider Active NPI

Bernadette Candis Marson, LCSW

  • Clinical Social Worker
  • Brentwood, NY
National Provider Identifier
1023214681
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
070655-1 Issued in NY
Practice address
3 Wilcox LN
Brentwood, NY 11717-7512
Phone
(631) 335-7278
NPI assigned
Jun 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 070655-1 NY Primary

Addresses

Primary practice location

3 Wilcox LN
Brentwood, NY 11717-7512

Mailing address

3 Wilcox LN
Brentwood, NY 11717-7512
Phone (631) 335-7278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080207000155 NY Practitioner - Clinical Social Worker 9335222868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Park PL
Suite 235
Fredonia, NY 14063-1764
Phone (716) 401-3360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070655-1NYMDClinical Social Worker

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023214681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WILCOX LN",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117177512",
            "telephone_number": "631-335-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WILCOX LN",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117177512",
            "telephone_number": "631-335-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSON",
        "first_name": "BERNADETTE",
        "middle_name": "CANDIS",
        "name_prefix": "Prof.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070655-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

Verify at the official NPI Registry.